HomeMy WebLinkAbout0313 ~ Qeclaration of Domicile and Ci~i~enship
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~~c~.~uco~~cuscurrcouar, : . . ~ .
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.~,.S..Ts ~70UN'1'Y. FLOAID~ :
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?t~b b my declan?ttoA ot DomkUe and Citisen~htp ta tbe State ot ~'torlda tha! I am GUa~ this do~r ia ~ocoedaoce. and tn '
~oatoeaatey with Seccioa 222.1T. Florida Satutes. ' -
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I was t em a ksal resideat ot -
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resided at - Howwer. I have eban~ad aAy domie~e to
l&n~t a~d Nuv~el ~
aad am sad lu~ve beea ~ botu~ fide resWent ol the State~~imee ~+7?
19_L.. : and I resiide at ~D ( I •
p fgttw?~d N~te~erl
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' - aad thts statemeat is to be taken as tq~r daluatioA of atizee~hip. actu~l kgal resideaee aad domic~e in the 3tate ot Florida.
Ii fOR THE PURPOSE Oi ENROLLING • IP ~OR HOMESTEAO PURPOSESi {
CNILOREN IN SCNOOL~ PLEA•SE STAYE ~ PLEASE CHECKS ~ }
YHEIR NAMES• . , '
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cCERK C~aCU1T Ca11RT ~
_ ..';.,vr VERIf1~0 ,
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~ I FURTNER CERTIFY thst I wtll register at my bcal addrass when tbe registntioa books rcopeo. aad e.omply writh all ;
other tequirements ot a legal tesideal ot this State. , ~
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_ I~F~~E~_ CE~H~~~~I~ ve oo intcntioa to return to my former docnicile. and I intcnd to remain iu
j ST . L u C t E^. , County. `
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Flor~da. petaianea~~ . ~
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Sworn to aad sub ~tbed bciore me this ~ Y dar ot ~
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A.D.19~.., .
}20GER P01 TRAS CIERK OF C iRCUI T COUtT
ST. LUC I E COUNTY, f I.OR 1 UA -
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ePUrY LERK .
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~ - ~i e~ . AGO fona 7!•~2
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